Active NPI
Manuel Marien Jr., DDS
- Pediatric Dentistry
- Fort Hood, TX
National Provider Identifier
1659333854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 20830
- Practice address
- 4431 68TH Street
HQ, USA Dentac
Fort Hood, TX 76544 - Phone
- (254) 287-2705
- Fax
- (254) 287-1786
- NPI assigned
- Apr 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 20830 | TX | Primary |
Addresses
Primary practice location
4431 68TH Street
HQ, USA Dentac
Fort Hood, TX 76544
Mailing address
4431 68TH Street
HQS, USA Dentac
Ft Hood, TX 76544-5054
Phone (254) 287-2705
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20830 | TX | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428969600000",
"number": "1659333854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4431 68TH STREET",
"address_2": "HQS, USA DENTAC",
"city": "FT HOOD",
"state": "TX",
"postal_code": "765445054",
"telephone_number": "254-287-2705",
"fax_number": "254-287-1786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4431 68TH STREET",
"address_2": "HQ, USA DENTAC",
"city": "FORT HOOD",
"state": "TX",
"postal_code": "76544",
"telephone_number": "254-287-2705",
"fax_number": "254-287-1786"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARIEN",
"first_name": "MANUEL",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-04",
"last_updated": "2015-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "20830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Hood, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.